We describe a case of posterior urethral valve with multiple urethroperineal fistulas. This association is extremely rare. The crucial point in the diagnosis is to distinguish these fistulas from the urethral duplications that actually guide the treatment. The presence of these fistulas in patients with posterior urethral valve may have a beneficial effect on renal function as it reduce the pressure on the bladder. On the other hand, incomplete valve ablation may contribute to the recurrence of the fistula.

We encountered a 9-year-old boy with a small bladder who had previously undergone multiple ureteroneocystostomies for unilateral refluxing megaureter. He underwent excision of the affected non-functioning kidney and ureterocystoplasty used the dilated regional ureter, in which the loop shaped urinary bladder was reconstructed without detubularization of the dilated ureter. The longterm postoperative course has been satisfactory. There have been no reports of ureterocystoplasty used a dilated ureter after multiple ureteroneocystostomies and none describing ureterocystoplasty in which the ureter was looped. This case is presented herein.

Wilms tumor (WT) is the most common childhood tumor of the kidney, which histologically mimics various stages of nephrogenesis. Spectrum of chemotherapy induced histopathological changes has been described in literature, and is one of the most important predictors of disease outcome and survival rates. Extensive chondroid differentiation and absence of necrosis in a post-chemotherapy nephrectomy specimen of a radiologically proven Wilms tumor is an unusual finding. Herein, we present the case of 6-year-old girl from South Africa who received a 10-week course of chemotherapy upon radiological diagnosis of WT, and post-surgery nephrectomy specimen revealed extensive mature cartilage island formation on histology raising diagnostic dilemma. Reporting of such cases is extremely important to recognize tumor morphological heterogeneity, particularly post- chemotherapy, and developing consensus for selecting further treatment and clinical follow-up.

Epidermoid inclusion cysts (EIC) is a disease caused by the nidation of the epidermal tissues and sebaceous materials into the dermal and subcutaneous layers. This entity is usually observed after trauma and surgical procedures. A 5-year-old boy with a ventral penile mass was admitted to our department. The history of the patient revealed that he was operated at the age of 1 year for hypospadias in a different medical center. The patient’s history also revealed that during the initial operation, a skin graft was used for covering urethroplasty. One year later the operation, a ventral penile mass was observed by his mother during wash. The mass continued to increase in size reaching of 1 cm in diameter. The mass was excised and the histopathological study revealed that the mass was compatible with an EIC. With 2 years of follow up the patient is disease free. EICs after penile surgical interventions may be a factor of anxiety for both the children and their parents. In order to avoid this unwanted complication, implantation of the superficial tissue layers into the deep the dermal and subcutaneous tissues should be avoided.

Bilateral single-system vaginal ectopic ureter (BSSVEU) is a very rare entity in pediatric urology. A 1-year-old girl was brought to outpatient clinic with continuous dribbling without normal voiding. The patient was diagnosed as BSSVEU by clinical findings, CT intravenous urography, genitoscopy and cystoscopy. Bilateral ureteric reimplantation was performed. Postoperative dry time was 2-3 hours after 3 months of follow-up and renal function was preserved at 3 months. Here, we report such a case and briefly discuss its diagnosis and management.